Computed tomography angiography and magnetic resonance imaging performance of acute segmental single compartment syndrome following an Achilles tendon repair: A case report and literature review / 中华创伤杂志(英文版)

Acute compartment syndrome of the lower extremity is a serious postinjury complication that requires emergency treatment. Early diagnosis is of paramount importance for a good outcome. Four muscle compartments in the calf (anterior, lateral, deep posterior, and superficial posterior) may be individually or collectively affected. Acute segmental single-compartment syndrome is an extremely rare condition characterized by high pressure in a single compartment space with threatening of the segmental tissue viability. In this case report, we describe a young man with Achilles tendon rupture who complained of postoperative pain in the anterior tibial region. Emergent computed tomography angiography and magnetic resonance imaging revealed local muscle edema. Segmental anterior compartment syndrome was diagnosed and fasciotomy was performed.

Pure alumina bearings with cementless stems versus sandwich bearings with cemented stems in total hip arthroplasty / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Ceramic bearing surfaces have been introduced to prevent osteolysis after total hip arthroplasty (THA), but little is known about the difference in clinical and radiological results between pure alumina and sandwich alumina bearings. The purpose of this study was to analyze the results obtained with third-generation alumina-on-alumina THA with two different designs both in liner and femoral stem fixation after a minimum follow-up of 4.2 years.</p><p><b>METHODS</b>The results of 195 primary alumina-on-alumina THAs in 167 patients were evaluated. The procedures were performed between January 1998 and October 2006. Three patients died and 11 patients were lost to follow-up, leaving a total of 153 patients (181 hips) available for study. In the 88 group A patients, 107 hips were implanted using pure alumina bearings with cementless femoral stems. These patients were followed for (6.84 ± 1.49) years. In the 65 group B patients, 74 hips were implanted using sandwich alumina ceramic bearings with cemented femoral stems. These patients had a follow-up period of (7.73 ± 1.60) years. Patients in both groups were evaluated clinically and radiographically.</p><p><b>RESULTS</b>One ceramic liner fracture occurred in group A and five took place in group B (P < 0.05), four of them revised for liner fracture. In each group, one acetabular shell migration happened without liner breakage and two hips developed deep infections, and all these six hips received revisions. Nine femoral components loosened in group B, with seven undergoing revisions. Kaplan-Meier survivorship at 5 years for revision of any component for any reason in group A was 96.26% compared to 90.54% in group B (P < 0.05). Better function was determined in group A (average Harris hip scores: 92.13 ± 2.85) than in group B (average Harris hip scores: 86.03 ± 4.21) and the difference was significant (P < 0.05). Squeaking was not recorded in either group.</p><p><b>CONCLUSIONS</b>The sandwich design of the acetabular bearings can not reduce the migration rate in ceramic bearings but increase the liner fracture rate compared to pure ceramic liners. The high loosening rate in fluted and taped designed cemented stems with sandwich liners warrant caution to their use.</p>

New Fibular Strut Graft Technique to Minimize Donor Site Complications / 대한정형외과학회잡지

PURPOSE: To evaluate the effectiveness of a periosteal sleeve preserced fibular strut graft for the minimization of donor site complications. MATERIALS AND METHODS: Between September 1998 and March 2005, 20 patients who were followed for more than 12 months after the fibular sturt graft for a bone defect using a periosteal sleeve preservation technique were evaluated. The mean age was 13.3 years (range, 2-29 years) and the mean follow-up period was 16.2 months (range, 12-36 months). RESULTS: The mean time for the union of the primary disease was 3.3 months (range, 2-6 months) and for regeneration of the donor site was 9.1 weeks (range, 4-12 weeks) in 13 cases. Partial regeneration developed in 6 cases and there was no regeneration in 1 case. There were 2 cases of donor site complications. CONCLUSION: The new fibular strut graft technique is very effective method for reconstruction of a bone defect with a minimization of the donor site complications particularly in children.